D2.58 - Relationship between the severity of atopic dermatitis and quality of life in children and adults attending an allergy clinic in Colombia between 2018-2020: A marginal mean weighting through stratification analysis (MMWS)

Atopic dermatitis (AD) is a chronic inflammatory skin condition that significantly impacts patients' quality of life (QoL). It is characterized by intense pruritus, sleep disturbances, and social and emotional challenges that worsen with disease severity. While global studies on AD effects exist, research in Latin America, particularly in Colombia, remains limited. This study aims to bridge this gap by analyzing the relationship between disease severity and QoL in pediatric and adult populations using validated instruments: EASI for severity and CDLQI and Skindex-29 for QoL assessment.

Analytical cross-sectional study that included children and adults with AD diagnosis treated at the Unimeq-ORL allergy clinic between 2018 and 2020. Disease severity was categorized as mild, moderate, or severe using the EASI index. QoL was assessed using CDLQI in children and Skindex-29 in adults. A propensity score model with Marginal Mean Weighting through Stratification (MMWS) was applied to control for selection bias and confounding factors, enabling a more equitable comparison between severity groups.

A total of 451 AD patients, including 370 children and 81 adults. Disease severity showed a significant association with QoL in both age groups. In children, median CDLQI scores increased with severity, ranging from 4.0 (mild) to 23.0 (severe). In adults, Skindex-29 scores followed a similar trend, with median values ranging from 17.5 (mild) to 76.0 (severe). The MMWS adjustment confirmed these trends by reducing the influence of confounding factors. Sociodemographic factors, such as belonging to a middle socioeconomic stratum (3-4), were associated with a slight improvement in children's QoL compared to lower strata. In adults, comorbidities such as asthma showed a significant association with QoL.

Disease severity, measured by EASI, is the primary determinant of QoL deterioration in children and adults with AD, highlighting the need for specific interventions in moderate and severe cases. The study also underscores the role of socioeconomic determinants in moderating disease impact, particularly in pediatric patients. The adjustment using the MMWS predictive model validated the robustness of the findings, reducing selection bias and improving the reliability of associations between severity and QoL.